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Horm Metab Res 2009; 41(12): 893-898
DOI: 10.1055/s-0029-1237359
Humans, Clinical

© Georg Thieme Verlag KG Stuttgart · New York

Comparative Effects of Telmisartan and Eprosartan on Insulin Sensitivity in the Treatment of Overweight Hypertensive Patients

R. Fogari1 , A. Zoppi1 , I. Ferrari1 , A. Mugellini1 , P. Preti1 , P. Lazzari1 , G. Derosa1
  • 1Department of Internal Medicine and Therapeutics, Centro Ipertensione e Fisiopatologia Cardiovascolare, University of Pavia, Pavia, Italy
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Publikationsverlauf

received 03.04.2009

accepted 16.07.2009

Publikationsdatum:
25. August 2009 (online)

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Abstract

The aim of this study was to compare the effect of telmisartan and eprosartan on insulin sensitivity in overweight hypertensive patients. Fifty overweight (BMI≥25 and <30 kg/m2) outpatients, aged 41–65 years, with mild to moderate hypertension [systolic blood pressure (SBP) >140 and diastolic blood pressure (DBP) ≥90 and ≤110 mmHg], after a 4-week placebo period, were randomized to receive telmisartan 80 mg or eprosartan 600 mg for 8 weeks. Following another 4-week placebo period, patients were crossed to the alternative regimen for further 8 weeks. At the end of each placebo and active treatment period, blood pressure (BP), insulin sensitivity (by euglycemic hyperinsulinemic clamp), fasting plasma glucose (FPG), insulin (FPI), total cholesterol (TC), LDL-C, HDL-C, and triglycerides (Tg) were evaluated. Insulin sensitivity was expressed as the amount of glucose infused during the last 30 min (glucose infusion rate, GIR) in μmol/min/kg. Both telmisartan and eprosartan significantly reduced SBP/DBP values (by a mean of 19.4/13.3 mmHg and 17.9/12.1 mmHg respectively, all p<0.001 vs. placebo), with no significant difference between the two treatments. GIR was significantly increased by telmisartan (2.25±0.61 μmol/min/kg, p<0.05 vs. placebo) but not by eprosartan (0.25±0.14 μmol/min/kg, p=ns), the difference between the two drugs being statistically significant (p<0.02). No change in FPG, FPI, HDL-C, and Tg was observed with either treatment. Telmisartan significantly reduced TC (−9.9 mg/dl, −5%, p<0.04 vs. placebo) and LDL-C (−8.8 mg/dl, −7%, p<0.03 vs. placebo), whereas eprosartan did not influence them. These findings indicate a superiority regarding an improvement of insulin sensitivity and plasma lipid profile in overweight hypertensives by telmisartan as compared to eprosartan, possibly related to the selective stimulating PPAR-γ property of telmisartan.

Key words

sartans - hyperinsulinemic clamp - hypertension - AT 1 blockers - insulin resistance - body weight

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Correspondence

R. Fogari

Clinica Medica II

Centro Ipertensione e Fisiopatologia Cardiovascolare

Department of Internal Medicine and Therapeutics

Piazzale Golgi 19

27100 Pavia

Italy

Telefon: +39/038/252 62 17

Fax: +39/038/252 62 59

eMail: r.fogari@unipv.it

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